Health professional partnerships and their impact on Aboriginal health : an occupational therapist's and Aboriginal health worker's perspective

Objective: To describe the extent and nature of demonstrated professional partnerships between occupational therapists and Aboriginal health workers in rural and remote communities of North Queensland. The study identifies ways in which professional partnerships improve client services and enhance occupational therapy outcomes through exploring the aspects of communication, collaboration and bridging cultural boundaries.---------- Design: Data collected via in-depth, semistructured telephone interviews. ---------- Setting: Aboriginal and mainstream health and human service organisations in rural and remote North Queensland. Rural and remote areas were identified using the Accessibility and Remoteness Index of Australia codes. ---------- Participants: Seven participants working in rural and remote areas of North Queensland, comprising four occupational therapists and three Aboriginal health workers. All participants were female. ---------- Results: Participants identified five core themes when describing the extent and nature of professional partnerships between occupational therapists and Aboriginal health workers. Themes include: professional interaction; perception of professional roles; benefits to the client; professional interdependence; and significance of Aboriginal culture. According to participants, when partnerships between occupational therapists and Aboriginal health workers were formed, clients received a more culturally appropriate service, were more comfortable in the presence of the occupational therapist, obtained a greater understanding of occupational therapy assessment and intervention, and felt valued in the health care process. ---------- Conclusions: This study substantiates the necessity for the formation of professional partnerships between occupational therapists and Aboriginal health workers. The findings suggest that participation in professional partnerships has positive implications for occupational therapists working with Aboriginal clients and Aboriginal health workers in rural and remote regions of North Queensland.

Firm social, cultural and intellectual capital : strategic indicators of international client satisfaction

Despite the increasing significance of the construction industry as an emerging sector of the Australian economy, there is inadequate research performed on construction design firms in terms of theoretical and empirical foundations. Although past research has identified the barriers and success factors for firm market entry, evidence suggests that to date no research has explicitly explored the sustainability of construction design firms in international markets. SMEs and their approach to firm internationalisation differ significantly from large manufacturing firms and a vast majority of construction design firms operate as SMEs. This paper develops a sustainable business model for construction design SMEs, which rely upon the development of clear Client Following (CF) versus Market Seeking (MS) strategies to support internal firm strategic and operational management. The understanding of these strategies is vital as the application of either will shape the design management approach of firms, which would in turn impact on the sustainability of these firms in foreign markets. Long-term sustainability of firms in international markets relies heavily upon client satisfaction. Client and project team participants’ communication during various design processes has often been problematic and the added difficulty of communicating across international boundaries further compounds the problem of capturing and maintaining client’s requirements. Therefore this paper develops a model for economic sustainability of Australian construction design firms working in international markets by exploring factors that affect client satisfaction across international boundaries, through the development of business performance indicators. These include not only the critical financial capital but also other ‘softer’ indicators, namely: social, cultural and intellectual capital. These act as a firm’s measure of success and the acquisition of this type of capital will provide significant advantages to firms’ success, hence sustainability in international markets.

Sharing knowledge at work : macro, social and relational individual influences on individual behavior

The impact of relations between an organization and its workers and the relations among workers on individual knowledge generation and sharing practices has not, to date, been addressed in an integrated way. This paper discusses the findings of a study analyzing issues at macro, locally-constructed and micro levels in a public sector organization, to identify and integrate the complex sets of mediators. Key factors were found to include (a) the contested nature of the process of knowledge construction, (b) the worker’s experience of the organization’s internal environment, (c) how the organization is understood to value knowledge sharing, (d) relations with colleagues, and (e) the perceived outcomes of knowledge sharing behaviors. Implications for practice are discussed.

Incorporating an economic model in the health impact assessment approach

The current policy decision making in Australia regarding non-health public investments (for example, transport/housing/social welfare programmes) does not quantify health benefits and costs systematically. To address this knowledge gap, this study proposes an economic model for quantifying health impacts of public policies in terms of dollar value. The intention is to enable policy-makers in conducting economic evaluation of health effects of non-health policies and in implementing policies those reduce health inequalities as well as enhance positive health gains of the target population. Health Impact Assessment (HIA) provides an appropriate framework for this study since HIA assesses the beneficial and adverse effects of a programme/policy on public health and on health inequalities through the distribution of those effects. However, HIA usually tries to influence the decision making process using its scientific findings, mostly epidemiological and toxicological evidence. In reality, this evidence can not establish causal links between policy and health impacts since it can not explain how an individual or a community reacts to changing circumstances. The proposed economic model addresses this health-policy linkage using a consumer choice approach that can explain changes in group and individual behaviour in a given economic set up. The economic model suggested in this paper links epidemiological findings with economic analysis to estimate the health costs and benefits of public investment policies. That is, estimating dollar impacts when health status of the exposed population group changes by public programmes – for example, transport initiatives to reduce congestion by building new roads/ highways/ tunnels etc. or by imposing congestion taxes. For policy evaluation purposes, the model is incorporated in the HIA framework by establishing association among identified factors, which drive changes in the behaviour of target population group and in turn, in the health outcomes. The economic variables identified to estimate the health inequality and health costs are levels of income, unemployment, education, age groups, disadvantaged population groups, mortality/morbidity etc. However, though the model validation using case studies and/or available database from Australian non-health policy (say, transport) arena is in the future tasks agenda, it is beyond the scope of this current paper.

The interactions of consumption characteristics on social norms

Purpose: An extended Theory of Planned Behavior (TPB) model tests how customer loyalty intentions may relate to subjective and descriptive norms. The study further determines whether consumption characteristics – product enjoyment and importance – moderate norms-loyalty relationships.----- Methodology: Using a two-study approach focusing on youth, an Australian study (n = 244) first augmented TPB with descriptive norm. A Singapore study (n = 415) followed up with how consumption characteristics might moderate norms-loyalty relationships. With both studies, linear regressions tested the relationships among the variables.----- Findings: Extending TPB with descriptive norm improved TPB’s predictive ability across studies. Further, product enjoyment and importance moderated the norms-loyalty relationships differently. Subjective norm related to loyalty intentions significantly with high enjoyment, whereas descriptive norm was significant with low enjoyment. Only subjective norm was significant with low importance.----- Research limitations: Single-item variables, self-reported questionnaires on intended rather than actual behavior, and not controlling for cultural differences between the two samples limit generalizablity.----- Practical implications: The significance of both norms suggests that mobile firms should reach youth through their peers. With youth, social pressure may be influential particularly with hedonic products. However, the different moderations of product enjoyment and importance imply that a blanket marketing strategy targeting youth may not work.----- Originality/Value: This study extends academic knowledge on the relationships between norms and customer loyalty, particularly with consumption characteristics as moderators. The findings highlight the importance of considering different norms with consumer behavior. The study should help mobile firms understand how social influences impact customer loyalty.

A learning community approach to doctoral education in the social sciences

The paper reports on the findings of a community learning approach to doctoral education involving scholarly writing groups (SWGs) which was developed and implemented in the context of a higher degree research programme within the social sciences in an Australian university. The research evaluated the impact of the teaching intervention on students' perceptions of the community learning experience, their knowledge of scholarly writing and their attitudes towards writing. The findings are suggestive of the advantages of community approaches to learning in higher degree research education as a supplement to independent supervision. The SWGs were associated with improvements in both participants' knowledge of scholarly writing and their attitudes towards writing. However, a variety of characteristics of doctoral education are potential impediments to the creation of ongoing and regular interactions in learning communities such as SWGs. The paper concludes that a flexible approach to the recognition and enhancement of community approaches to learning is required to acknowledge the complex and diverse context of contemporary doctoral education.

The theory of planned behaviour applied to young people's use of social networking websites

Despite the increasing popularity of social networking websites (SNWs), very little is known about the psychosocial variables which predict people’s use of these websites. The present study used an extended model of the theory of planned behaviour (TPB), including the additional variables of self-identity and belongingness, to predict high level SNW use intentions and behaviour in a sample of young people aged between 17 and 24 years. Additional analayses examined the impact of self-identity and belongingness on young people’s addictive tendencies towards SNWs. University students (N = 233) completed measures of the standard TPB constructs (attitude, subjective norm and perceived behavioural control), the additional predictor variables (self-identity and belongingness), demographic variables (age, gender, and past behaviour) and addictive tendencies. One week later, they reported their engagement in high level SNW use during the previous week. Regression analyses partially supported the TPB, as attitude and subjective norm signficantly predicted intentions to engage in high level SNW use with intention signficantly predicting behaviour. Self-identity, but not belongingness, signficantly contributed to the prediction of intention, and, unexpectedly, behaviour. Past behaviour also signficantly predicted intention and behaviour. Self-identity and belongingness signficantly predicted addictive tendencies toward SNWs. Overall, the present study revealed that high level SNW use is influenced by attitudinal, normative, and self-identity factors, findings which can be used to inform strategies that aim to modify young people’s high levels of use or addictive tendencies for SNWs.

How does ambulance service utilisation impact demand for Emergency Departments in Queensland, Australia?

Background: There are indications that pre-hospital emergency care and management of patients can help reduce the demand for hospital emergency departments (EDs). Ambulance services play a significant role at this stage of care. In 2003, the Queensland Government introduced a Community Ambulance Cover (CAC) levy in return for a free ambulance service at the point of access to all Queenslanders. This may have led to the impression in consumers of an entitlement to free ambulance services under any circumstances regardless of the urgency of the matter which may have in turn contributed to the crowding of EDs in Queensland. Objectives: This paper aims to answer the following questions: - How many patients arrive at hospital EDs by ambulance in Queensland, compared to other modes of arrival? - How has this changed over time, particularly after the CAC introduction in 2003? What percentage of ambulance arrivals are urgent ED patients? - Has the perceived free ambulance services created extra demand for EDs in Queensland, compared with other Australian jurisdictions that charge patients for ambulance services? Methods: We will secondary analyse the data from sources such as Queensland Ambulance Services, Department of Health and Australian Bureau of Statistics to answer the research questions. Findings and Conclusions Queensland has the highest utilization rate of ambulance services (about 18% in 2007-08) and the highest annual growth rate in demand for these services (7.7% on average since 2000-01), well above the population growth. On the other hand, the proportion of ED patients arriving by ambulance in Queensland has increased by about 4% annually. However, when compared with other states and territories with charge at the point of access, it seems that the growth in demand for EDs cannot be explained solely or mainly by CAC or ambulance utilisation in Queensland.

Globalization, frontier masculinities and violence : booze, blokes and brawls

Over the last two decades, two new trajectories have taken hold in criminology - the study of masculinity and crime, after a century of neglect, and the geography of crime. This article brings both those fields together to analyse the impact of globalisation in the resources sector on frontier cultures of violence. This paper approaches this issue through a case study of frontier masculinities and violence in communities at the forefront of generating resource extraction for global economies. This paper argues that the high rates of violence among men living in work camps in these socio-spatial contexts cannot simply be understood as individualised expressions of psycho-pathological deficit or social disorganisation. Explanations for these patterns of violence must also consider a number of key subterranean convergences between globalising processes and the social dynamics of male-on-male violence in such settings.

The impact of health information technology on the quality of medical and health care : a systematic review

Objective: To systematically review the published evidence of the impact of health information technology (HIT) on the quality of medical and health care specifically clinicians’ adherence to evidence-based guidelines and the corresponding impact this had on patient clinical outcomes. In order to be as inclusive as possible the research examined literature discussing the use of health information technologies and systems in both medical care such as clinical and surgical, and other health care such as allied health and preventive services.----- Design: Systematic review----- Data Sources: Relevant literature was systematically searched on English language studies indexed in MEDLINE and CINAHL(1998 to 2008), Cochrane Library, PubMed, Database of Abstracts of Review of Effectiveness (DARE), Google scholar and other relevant electronic databases. A search for eligible studies (matching the inclusion criteria) was also performed by searching relevant conference proceedings available through internet and electronic databases, as well as using reference lists identified from cited papers.----- Selection criteria: Studies were included in the review if they examined the impact of Electronic Health Record (EHR), Computerised Provider Order-Entry (CPOE), or Decision Support System (DS); and if the primary outcomes of the studies were focused on the level of compliance with evidence-based guidelines among clinicians. Measures could be either changes in clinical processes resulting from a change of the providers’ behaviour or specific patient outcomes that demonstrated the effectiveness of a particular treatment given by providers. ----- Methods: Studies were reviewed and summarised in tabular and text form. Due to heterogeneity between studies, meta-analysis was not performed.----- Results: Out of 17 studies that assessed the impact of health information technology on health care practitioners’ performance, 14 studies revealed a positive improvement in relation to their compliance with evidence-based guidelines. The primary domain of improvement was evident from preventive care and drug ordering studies. Results from the studies that included an assessment for patient outcomes however, were insufficient to detect either clinically or statistically important improvements as only a small proportion of these studies found benefits. For instance, only 3 studies had shown positive improvement, while 5 studies revealed either no change or adverse outcomes.----- Conclusion: Although the number of included studies was relatively small for reaching a conclusive statement about the effectiveness of health information technologies and systems on clinical care, the results demonstrated consistency with other systematic reviews previously undertaken. Widescale use of HIT has been shown to increase clinician’s adherence to guidelines in this review. Therefore, it presents ongoing opportunities to maximise the uptake of research evidence into practice for health care organisations, policy makers and stakeholders.

The impact of “empirical facts” on legal scholarship and legal research training

Lawyers have traditionally viewed law as a closed system, and doctrinal research has been the research methodology used most widely in the profession. This reflects traditional concepts of legal reasoning. There is a wealth of reliable and valid social science data available to lawyers and judges. Judges in fact often refer to general facts about the world, society, institutions and human behaviour (‘empirical facts’). Legal education needs to prepare our students for this broader legal context. This paper examines how ‘empirical facts’ are used in Australian and other common law courts. Specifically, the paper argues that there is a need for enhanced training in non-doctrinal research methodologies across the law school curriculum. This should encompass a broad introduction to social science methods, with more attention being paid to a cross-section of methodologies such as content analysis, comparative law and surveys that are best applied to law.

Impact of music therapy to promote positive parenting and child development

The effectiveness of a 10-week group music therapy program for marginalized parents and their children aged 0–5 years was examined. Musical activities were used to promote positive parent–child relationships and children’s behavioral, communicative and social development. Participants were 358 parents and children from families facing social disadvantage, young parents or parents of a child with a disability. Significant improvements were found for therapist-observed parent and child behaviors, and parent-reported irritable parenting, educational activities in the home, parent mental health and child communication and social play skills. This study provides evidence of the potential effectiveness of music therapy for early intervention.

Vitamin D and sun protection : the impact of mixed public health messages in Australia

Exposure of the skin to sunlight can cause skin cancer and is also necessary for cutaneous vitamin D production. Media reports have highlighted the purported health benefits of vitamin D. Our aim was to examine attitudes and behaviours related to sun protection and vitamin D. A cross-sectional study of 2,001 residents in Queensland, Australia aged 20-70 years was undertaken. Information collected included: skin cancer risk factors; perceptions about levels of sun exposure required to maintain vitamin D; belief that sun protection increases risk of vitamin D deficiency; intention, and actual change in sun protection practices for adults and children. Multivariate models examined predictors of attitudinal and behavioural change. One-third (32%) believed a fair-skinned adult, and 31% thought a child required at least 30 minutes per day in summer sun to maintain vitamin D levels. Reductions in sun protection were reported by 21% of adults and 14% of children. Factors associated with belief that sun protection may result in not obtaining enough vitamin D included aged ≥ 60 years (OR=1.35, 95% CI 1.09-1.66) and having skin that tanned easily (OR=1.96, 95% CI 1.38-2.78). Participants from low income households, and those who frequently used sun protective clothing were more likely to have reduced sun protection practices (OR=1.33, 95% CI 1.10-1.73 and OR=1.73, 95% CI 1.36-2.20, respectively). This study provides evidence of reductions in sun protection practices in a population living in a high UV environment. There is an urgent need to re-focus messages regarding sun exposure and for continued sun protection practices.

From social butterfly to urban citizen workshop

Web applications such as blogs, wikis, video and photo sharing sites, and social networking systems have been termed ‘Web 2.0’ to highlight an arguably more open, collaborative, personalisable, and therefore more participatory internet experience than what had previously been possible. Giving rise to a culture of participation, an increasing number of these social applications are now available on mobile phones where they take advantage of device-specific features such as sensors, location and context awareness. This workshop made a contribution towards exploring and better understanding the opportunities and challenges provided by tools, interfaces, methods and practices of social and mobile technology that enable participation and engagement. It brought together a group of academics and practitioners from a diverse range of disciplines such as computing and engineering, social sciences, digital media and human-computer interaction to critically examine a range of applications of social and mobile technology, such as social networking, mobile interaction, wikis (eg., futuremelbourne.com.au), twitter, blogging, virtual worlds (eg, hub2.org), and their impact to foster community activism, civic engagement and cultural citizenship.

The impact of delayed blood centrifuging, choice of collection tube, and type of assay on 25-hydroxyvitamin D concentrations

Studies have examined the associations between cancers and circulating 25-hydroxyvitamin D [25(OH)D], but little is known about the impact of different laboratory practices on 25(OH)D concentrations. We examined the potential impact of delayed blood centrifuging, choice of collection tube, and type of assay on 25(OH)D concentrations. Blood samples from 20 healthy volunteers underwent alternative laboratory procedures: four centrifuging times (2, 24, 72, and 96 h after blood draw); three types of collection tubes (red top serum tube, two different plasma anticoagulant tubes containing heparin or EDTA); and two types of assays (DiaSorin radioimmunoassay [RIA] and chemiluminescence immunoassay [CLIA/LIAISON®]). Log-transformed 25(OH)D concentrations were analyzed using the generalized estimating equations (GEE) linear regression models. We found no difference in 25(OH)D concentrations by centrifuging times or type of assay. There was some indication of a difference in 25(OH)D concentrations by tube type in CLIA/LIAISON®-assayed samples, with concentrations in heparinized plasma (geometric mean, 16.1 ng ml−1) higher than those in serum (geometric mean, 15.3 ng ml−1) (p = 0.01), but the difference was significant only after substantial centrifuging delays (96 h). Our study suggests no necessity for requiring immediate processing of blood samples after collection or for the choice of a tube type or assay.